Quality of life and factors associated among public university employees retired due to disabilities

Abstract Objective: to analyze quality of life and factors associated among public university employees retired due to disabilities. Method: a cross-sectional study conducted with a sample of public university employees retired due to disabilities. A characterization questionnaire and the World Health Organization Quality of Life - Disabilities instrument were applied via telephone or online contacts from November 2019 to September 2020. The associated factors were verified through multiple linear regression. Results: of the 80 retirees due to disability, 15% were professors and 85% had a technical-administrative career. As for the factors associated with Quality of Life, continuous medication use (βadj: -0.25; p=0.02) and problems in the nervous system (βadj: -0.21; p<0.05) were associated with the Overall domain; continuous medication use (βadj: -0.23; p=0.04), to the Physical domain; smoking (βadj: -0.21; p<0.05) and mental and behavioral disorders (βadj: -0.21; p<0.01), to the Psychological domain; smoking (βadj: -0.46; p<0.01) and respiratory (βadj: -0.21; p=0.03) and circulatory (βadj: -0.21; p=0.03) problems, to the Social domain; smoking (βadj: -0.33; p<0.01) and problems in the nervous system (βadj: -0.22; p=0.04), to the Environmental domain; mental and behavioral disorders, to the Disabilities module (βadj: -0.29; p<0.01) and to the Discrimination domain (βadj: -0.21; p<0.05); and smoking (βadj: -0.32; p<0.01) and problems in the nervous system (βadj: -0.20; p<0.05), to the Inclusion domain. The Autonomy domain did not present any association. Conclusion: the retirees under study presented impaired Quality of Life.

QoL during the professional career, the greater the desire not to dissociate from work (9) . Retirement is a singular transition period intrinsic to the aging process, and its association with higher satisfaction with life can exert positive effects on overall health, functioning and QoL.
However, people who retire due to disabilities undergo a particular experience and differ from those that chose to retire based on service time or age. Such being the case, it can be inferred that disability retirement can impose harms to these people's QoL.
The concept of QoL adopted in this study is related to subjective aspects related to social, cultural and environmental issues, and can be defined from how individuals perceive their life in the context in which they are inserted in terms of culture, values, goals, expectations, rules and concerns (10) .
Given the above, this study is relevant because may provide reflections on the QoL of people retired due to disability, providing subsidies for the implementation of measures that seek to prevent and promote the workers' health and, consequently, avoid early retirement. It is worth emphasizing that the studies evaluating the relationship between retirement and life satisfaction were carried out in high-income countries such as the United States and Europe, and that few were carried out in low-or middle-income countries such as Brazil, in which the living conditions and social protection schemes are more unfavorable (11) . The objective of this research study was to analyze Quality of Life and factors associated among public university employees retired due to disabilities.

Type of study
This is a cross-sectional study with a quantitative approach. As such, description of this section followed the recommendations set forth in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).  respectively (14)(15) . The WHOQOL-DIS has answers provided on five-point Likert scales and does not have a cutoff score; however, the scores obtained in the domains must be transformed into a scale from 0 to 100, where the closer to zero, the worse the QoL, and the closer to 100, the better the QoL (12-13) . The WHOQOL-DIS domains presented correlations with the sociodemographic characterization, clinical and occupational variables, as described in Table 2. The multiple models of the WHOQOL-DIS domains are presented in Table 3. Rev. Latino-Am. Enfermagem 2023;31:e3816.

Study population and locus
It was verified that overall QoL was reduced for the retirees due to problems in the nervous system and on continuous medication use, especially in the older ones.
Physical QoL was significantly reduced for the retirees due to Mental and Behavioral Disorders (MBDs), mainly among those of more advanced age. Psychological QoL was significantly reduced for the smokers and retirees due to MBDs, also associated with increased age. Social QoL was significantly reduced for smokers and retirees due to respiratory and circulatory problems, regardless of age and gender. Environmental QoL was also reduced for smokers and retirees due to problems in the nervous system, regardless of age and gender.
Overall QoL related to disability was reduced for the retirees due to MBDs, especially in the older ones. In the Discrimination domain, those who retired due to MBDs and of more advanced age presented lower QoL levels.
Similarly, retirees due to MBDs and smokers obtained lower scores in the Inclusion domain. A study carried out in China showed that, for smokers, the mean chances of enjoying better QoL were 11.65% lower than when they did not smoke, highlighting the need for anti-smoking campaigns to clearly indicate the negative effect of tobacco use on people's QoL (32) .
In the current study, the QoL domains affected by MBDs were not related to gender, although they were associated with increased age. A Spanish study that evaluated the QoL of people with severe mental illness identified that women's overall mean QoL in the physical component was significantly lower than that of men, and that the factors associated with QoL also differed by gender (33) .

It should be noted that not all people affected by
MBDs need to retire, and the universities under study have a work readaptation process, with functions compatible with their health condition assigned without loss of profits. Such being the case, only those unable to work retire due to disabilities. In addition, whether retired or readapted, people with MBDs need to be reintegrated into the citizenship process and its basic requirements, that is, accessibility to social rights such as health, education, social assistance, social security, housing, work and income, food security, mobility and public transportation